In South Africa social grants address key social determinants of health such as food insecurity, access to health services, income and early childhood development. About 17 million South Africans receive social grants every month. Of these, about 12 million are children in receipt of the child support grant.
For many households, the child support grant and the old age grant are the only forms of predictable income that they rely on.
While many in the medical profession - as well as beneficiaries - have long bemoaned the inadequacy of the child support grant to meet even the most basic needs of its beneficiaries, such as adequate nutrition, there has never been any doubt that it's indispensable to millions of households across the country.
The South African government has allocated R151.6-billion to social grants in its 2017/2018 budget. There are four main grants that are disbursed under the system: an old age grant for pensioners over the age of 60 of US$ 120 (R1600) and for those over 75 a grant of US$ 122 (R1620); a disability and care dependency grant of US$ 120 (R1600); a foster care grant of US$ 69 (R920), and child support grant of US$ 28 (R380) a month for children under the age of 18.
The importance of South Africa's grants system is worth revisiting in the wake of a crisis unfolding over their disbursement. The country's Constitutional Court ruled 3 years ago that the contract of the current service provider Cash Paymaster Systems was illegal - and the Department of Social Development which the South African Social Security Agency falls under, needed to find a new service provider. It has failed to do so, placing the disbursements of the grants in jeopardy.
The child support grant and the old age pensioner's grant make up by far the biggest allocation. Should they not be disbursed, many households will lose the only source of income they have. The impact on households would be profound.
Why the grants matter
Mothers and caregivers use it to buy food, pay for school fees and other school related costs as well as health care. This includes transport to clinics or hospital, and for purchasing medication.
The importance of the child support grant becomes ever more salient when one listens to the stories of those who - though they are eligible - are not in receipt of the grant.
Anecdotal evidence in my research has shown that children who don't receive the grant experience extended periods of hunger, have difficulties accessing health care services especially in remote areas where facilities are far, and have problems meeting school-related expenses.
The old age grant is about four times the amount of the child support grant. Despite the fact that the beneficiaries are the elderly, the grant is used to care for entire households, essentially bearing the burden and closing the gap created by high rates of unemployment in the country.
It's also associated with improved nutritional outcomes for children in poor households.
Taken together, these two grants are doing the work of government in South Africa: providing for those who have been left out in the cold.
Any threat to the distribution of the grants would have catastrophic consequences for individuals and households across South Africa. Households will lose the only source of income they have. Children and adults alike will go without food. Some children who live in remote rural areas far from health facilities will miss important immunisation visits at the clinics.
The most vulnerable people in society and those who need the help of the government most faces the biggest risk to any threat to their disbursement.
Disclosure statement: Wanga Zembe-Mkabile has received funding from the National Research Foundation, the National Department of Health and the Centre of Excellence for Food Security. She is also a member of the People's Health Movement and a board director at the Southern African Social Policy Research Institute NPC.